Risk factors and associated outcomes of hospital readmission in COPD: A systematic review - 12/11/20
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Abstract |
Background |
Chronic obstructive pulmonary disease (COPD) is a leading cause of unplanned readmission. There is need to identify risk factors for, and strategies to prevent readmission in patients with COPD.
Aim |
To systematically review and summarise the prevalence, risk factors and outcomes associated with rehospitalisation due to COPD exacerbation.
Method |
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Five databases were searched for relevant studies.
Results |
Fifty-seven studies from 30 countries met the inclusion criteria. The prevalence of COPD-related readmission varied from 2.6 to 82.2% at 30 days, 11.8–44.8% at 31–90 days, 17.9–63.0% at 6 months, and 25.0–87.0% at 12 months post-discharge. There were differences in the reported factors associated with readmissions, which may reflect variations in the local context, such as the availability of community-based services to care for exacerbations of COPD. Hospitalisation in the previous year prior to index admission was the key predictor of COPD-related readmission. Comorbidities (in particular asthma), living in a deprived area and living in or discharge to a nursing home were also associated with readmission. Relative to those without readmissions, readmitted patients had higher in-hospital mortality rates, shorter long-term survival, poorer quality of life, longer hospital stay, increased recurrence of subsequent readmissions, and accounted for greater healthcare costs.
Conclusions |
Hospitalisation in the previous year was the principal risk factor for COPD-related readmissions. Variation in the prevalence and the reported factors associated with COPD-related readmission indicate that risk factors cannot be generalised, and interventions should be tailored to the local healthcare environment.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Hospitalisation in the previous year is key predictor of COPD-related readmission. |
• | COPD-related readmissions are associated with higher in-hospital mortality rates. |
• | Prevalence of COPD readmission varies between countries. |
• | Determinants of COPD readmission are not readily generalisable. |
• | Interventions should be tailored to the local healthcare environment. |
Keywords : COPD, Readmission, Risk factors, Consequences
Abbreviations : 6MWD, BMI, BODE, CCI, COPD, CRP, ECOPD, EKG, FEV1, FVC, GOLD, HADS, ICS, IHM, LABA, LOS, LTOT, MRC, NI, PaCO2, SGRQ, WBC
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Vol 173
Article 105988- novembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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